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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

In office

Sclerotherapy

An office injection that shrinks internal hemorrhoids and scars them into place — best when bleeding is the main symptom, and often the safest office option for patients on blood thinners.

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Setting
In office
Anesthesia
Usually none needed — the injection is placed above the nerve line, and most people feel pressure rather than pain.
Back to work
Most people return to normal activities the same day.
Pain relief
Most people need little or nothing afterward — an over-the-counter pain reliever and a warm sitz bath cover any feeling of fullness.
Success rate
75-90%
Recurrence
10-30%

What it is

What is Sclerotherapy?

Sclerotherapy is a minimally invasive, office-based procedure used to treat symptomatic Grade I and II internal hemorrhoids. The procedure involves injecting a chemical solution, known as a sclerosant, into the submucosal tissue at the base of the internal hemorrhoid. This chemical irritates the blood vessels, causing them to collapse and form scar tissue. The scarring fixes the hemorrhoid to the underlying muscle, preventing prolapse, and reduces the blood supply, causing the hemorrhoid to shrink.

Am I a candidate?

Who is a Good Candidate for Sclerotherapy?

Sclerotherapy is an ideal treatment for patients with symptomatic Grade I and select Grade II internal hemorrhoids, particularly those whose primary symptom is bleeding. It is a good option for patients who have failed conservative management with diet and lifestyle changes and for those who are on anticoagulation therapy, as the risk of bleeding is very low. It is not recommended for prolapsing (Grade III-IV) or external hemorrhoids.

How it's done

  1. 1A small scope (an anoscope) is placed to see the internal hemorrhoids.
  2. 2A small amount of sclerosing solution — commonly 5% phenol in oil — is injected at the base of the hemorrhoid, above the nerve line.
  3. 3The solution scars down the vessels feeding the hemorrhoid and fixes the tissue in place, so the hemorrhoid shrinks and bleeding improves.
  4. 4The visit takes a few minutes and you go home right away. Repeat injections spaced weeks apart are common.

What to expect

  1. Same day

    Back to normal activities. A mild feeling of fullness or pressure can last a day or so.

  2. First days

    Minor spotting is possible. Keep stools soft with fiber and fluids, and avoid straining.

  3. Following weeks

    The hemorrhoid shrinks as scar tissue forms. A follow-up visit checks the response — more than one session is often needed, and that's expected rather than a failure.

  4. Call right away if

    Fever, trouble urinating, or pain that gets worse instead of better — serious problems after sclerotherapy are rare, but they need prompt evaluation.

Risks & considerations

What are the Risks?

Sclerotherapy is a very safe procedure with a low complication rate. Most patients experience little to no discomfort. Potential risks are rare but can include:

  • Pain or Discomfort: A sensation of rectal fullness or pressure may occur but is usually mild and transient. Severe pain is rare and may indicate the injection was placed too low or too deep.
  • Bleeding: Minor, self-limited bleeding can occur but is uncommon.
  • Submucosal Abscess: Infection at the injection site is a rare complication.
  • Prostatitis or Epididymitis: In men, sclerosant can rarely migrate and cause inflammation of the prostate or epididymis.
  • Recurrence: Hemorrhoid symptoms can recur over time, and repeat treatments may be necessary.

Sources

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